| NPI | 1295906345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 53878) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 100204) |
| 207R00000X Internal Medicine (Licence: ME 018696) | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2023-09-20 |